Abstract
BackgroundIt is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness.MethodsThis study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n = 364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning.ResultsIn multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness.ConclusionsAdverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory.Trials registrationThis trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374.
Highlights
It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes
Few studies have examined the use of alcohol and other drugs in detail; for example, what frequency and type of substance use is associated with chains of risk? The current study further examines the relationship between adverse childhood events and a variety of adult health outcomes among a sample of homeless adults with mental illness in Vancouver, British Columbia
Declined items ranged from 9.2% to 10.9% and “don’t know” responses ranged from 2.2% to 9.7%
Summary
It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. Using a sample of adults served by a large health maintenance organization in California, a growing body of research has established a strong dose– response relationship between the number of adverse childhood experiences and poor health outcomes in adulthood including alcohol and drug use, mental health, physical illness, and a variety of risk behaviours [6,7,8]. This sample includes individuals with private health insurance and, is not generalizable to people with histories of chronic homelessness and mental illness
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
